Skip to main content
Top
Published in: Indian Journal of Surgical Oncology 1/2018

01-03-2018 | Original Article

Skeletal Metastasis—an Epidemiological Study

Authors: Balaji Zacharia, Dhiyaneswaran Subramaniam, Jerin Joy

Published in: Indian Journal of Surgical Oncology | Issue 1/2018

Login to get access

Abstract

Metastasis is the commonest bone tumors. The commonest primary metastasis to the bone are the breast, lung, prostate, kidney, and thyroid. The bone is the third common site of metastatic disease, only the lung and the liver have higher metastatic rate than skeleton. We have no epidemiological studies conducted to evaluate the various aspects of skeletal metastasis like age, sex distribution, presentation, common sites of primary and associated secondary metastases, and investigation from Indian subcontinent. Here we are presenting the first epidemiological study of skeletal metastasis from our region. We have conducted a prospective descriptive study in the Departments of Orthopedics and Radiotherapy, Government Medical College, Kozhikode, during the period of 2007 to 2009. One hundred eleven patients were included in the study above the age of 30 years. Clinical examination and investigation were done on these patients. Skeletal metastasis commonly occurs in the fifth decade of life with modest male preponderance. In most of the cases, the primary site of malignancy was undetected at the time of presentation. Pain was the commonest presented complaint of the patient. The spine is the commonest site affected and the lung was the common site of primary metastasis. Most of the cases were detected by radiogram and confirmation was obtained by minimally invasive technique like FNAC or CNB.
Literature
1.
go back to reference Shimada H, Setoguchi T, Nakamura S, Yokouchi M, Ishidou Y, Tominaga H, Kawamura I, Nagano S, Komiya S (2015) Evaluation of prognostic scoring systems for bone metastases using single-center data. Mol Clin Oncol 3(6):1361–1370CrossRefPubMedPubMedCentral Shimada H, Setoguchi T, Nakamura S, Yokouchi M, Ishidou Y, Tominaga H, Kawamura I, Nagano S, Komiya S (2015) Evaluation of prognostic scoring systems for bone metastases using single-center data. Mol Clin Oncol 3(6):1361–1370CrossRefPubMedPubMedCentral
2.
go back to reference Mundy GR (2002) Metastasis to bone: causes, consequences and therapeutic opportunities. Nat RevCancer 2:584CrossRef Mundy GR (2002) Metastasis to bone: causes, consequences and therapeutic opportunities. Nat RevCancer 2:584CrossRef
3.
go back to reference Buckwalter JA, Brandser EA (1997) Metastatic disease of the skeleton. Am Fam Physician 55(5):1761–1768PubMed Buckwalter JA, Brandser EA (1997) Metastatic disease of the skeleton. Am Fam Physician 55(5):1761–1768PubMed
4.
go back to reference Davies AM, Sundaram M, Steven JJ (eds) Imaging of bone tumors and tumor-like lesions: techniques and applications. Medical radiology and diagnostic imaging. Springer, Berlin Heidelberg Davies AM, Sundaram M, Steven JJ (eds) Imaging of bone tumors and tumor-like lesions: techniques and applications. Medical radiology and diagnostic imaging. Springer, Berlin Heidelberg
6.
go back to reference Devita, Hellman, and Rosenberg: Cancer, principles and practice of oncology ... Lawrence, Theodore S;Rosenberg, Steven A. Philadelphia:Wolters Kluwer, [2016]....Principles and practice of oncology review: Govindan, Ramaswamy. 3rd ed Devita, Hellman, and Rosenberg: Cancer, principles and practice of oncology ... Lawrence, Theodore S;Rosenberg, Steven A. Philadelphia:Wolters Kluwer, [2016]....Principles and practice of oncology review: Govindan, Ramaswamy. 3rd ed
7.
go back to reference Ugras N, Yalcinkaya U, Akesen B, Kanat O (2014) Solitary bone metastases of unknown origin. Acta Orthop Belg 80(1):139–143PubMed Ugras N, Yalcinkaya U, Akesen B, Kanat O (2014) Solitary bone metastases of unknown origin. Acta Orthop Belg 80(1):139–143PubMed
9.
go back to reference Healey JH, Turnbull AD, Miedema B, Lane JM (1986) Acrometastases: a study of twenty-nine patients with osseous involvement of the hands and feet. J Bone Joint Surg Am 68(5):743–746CrossRefPubMed Healey JH, Turnbull AD, Miedema B, Lane JM (1986) Acrometastases: a study of twenty-nine patients with osseous involvement of the hands and feet. J Bone Joint Surg Am 68(5):743–746CrossRefPubMed
10.
go back to reference Libson E, Bloom RA, Husband JE (1987) Husband: metastatic tumors of bones of the hand and foot: a comparative review and report of 43 additional cases affiliated with ….Department of Radiology, Royal Marsden Hospital, Dennis J. Stoker Skeletal Radiology 16(5):387–392 Libson E, Bloom RA, Husband JE (1987) Husband: metastatic tumors of bones of the hand and foot: a comparative review and report of 43 additional cases affiliated with ….Department of Radiology, Royal Marsden Hospital, Dennis J. Stoker Skeletal Radiology 16(5):387–392
11.
go back to reference Hage WD, Aboulafia AJ, Aboulafia DM (2000) Aboulafia: incidence, location and diagonostic evaluation of metastatic bone disease. Orthop Clin North Am 31(4):515–528 Hage WD, Aboulafia AJ, Aboulafia DM (2000) Aboulafia: incidence, location and diagonostic evaluation of metastatic bone disease. Orthop Clin North Am 31(4):515–528
12.
13.
go back to reference Weinstein JN (1992) Differential diagnosis and surgical treatment of pathologic spine fractures. Instr Course Lect 41:301–315PubMed Weinstein JN (1992) Differential diagnosis and surgical treatment of pathologic spine fractures. Instr Course Lect 41:301–315PubMed
14.
go back to reference Springfield DS (1982) Mechanism of metastasis. Clin Orthop 169:15 Springfield DS (1982) Mechanism of metastasis. Clin Orthop 169:15
15.
go back to reference Ali IU et al (1987) Reduction to homozygosity of genes on chromosomes 11 in human breast neoplasia. Science 238(4824):185–188CrossRefPubMed Ali IU et al (1987) Reduction to homozygosity of genes on chromosomes 11 in human breast neoplasia. Science 238(4824):185–188CrossRefPubMed
16.
go back to reference Arguello F, Baggs RB, Frantz CN (1988) A murine model of experimental metastasis to bone and bone marrow. Cancer Res 48(23):6876–6881PubMed Arguello F, Baggs RB, Frantz CN (1988) A murine model of experimental metastasis to bone and bone marrow. Cancer Res 48(23):6876–6881PubMed
17.
go back to reference Cher ML, Bova GS, Moore DH, Small EJ, Carroll PR, Pin SS, Epstein JI, Isaacs WB, Jensen RH (1996) Genetic alterations in untreated metastases and androgen-independent prostate cancer detected by comparative genomic hybridization and allelotyping. Cancer Res 56(13):3091–3102PubMed Cher ML, Bova GS, Moore DH, Small EJ, Carroll PR, Pin SS, Epstein JI, Isaacs WB, Jensen RH (1996) Genetic alterations in untreated metastases and androgen-independent prostate cancer detected by comparative genomic hybridization and allelotyping. Cancer Res 56(13):3091–3102PubMed
18.
go back to reference Harris M, Howell A, Chrissohou M, Swindell RI, Hudson M, Sellwood RA (1984) A comparison of the metastatic pattern of infiltrating lobular carcinoma and infiltrating ductcarcinoma of the breast. Br J Cancer 50(1):23–30CrossRefPubMedPubMedCentral Harris M, Howell A, Chrissohou M, Swindell RI, Hudson M, Sellwood RA (1984) A comparison of the metastatic pattern of infiltrating lobular carcinoma and infiltrating ductcarcinoma of the breast. Br J Cancer 50(1):23–30CrossRefPubMedPubMedCentral
20.
21.
24.
go back to reference Roudier MP, Vesselle H, True LD et al (2003) Bone histology at autopsy and matched bone scintigraphy findings in patients with hormone refractory prostate cancer: the effect of bisphosphonate therapy on bone scintigraphy results. Clin Exp Metastasis 20:171–180CrossRefPubMed Roudier MP, Vesselle H, True LD et al (2003) Bone histology at autopsy and matched bone scintigraphy findings in patients with hormone refractory prostate cancer: the effect of bisphosphonate therapy on bone scintigraphy results. Clin Exp Metastasis 20:171–180CrossRefPubMed
25.
go back to reference Hanna SL, Fletcher BD, Fairclough DL et al (1991) Magnetic resonance imaging of disseminated bone marrow disease in patients treated for malignancy. Skelet Radiol 20:79CrossRef Hanna SL, Fletcher BD, Fairclough DL et al (1991) Magnetic resonance imaging of disseminated bone marrow disease in patients treated for malignancy. Skelet Radiol 20:79CrossRef
27.
go back to reference Hamaoka T, Madewell JE, Podoloff DA, Hortobagyi GN, Ueno NT (2004) Bone imaging in metastatic breast cancer. J Clin Oncol 22(14):2942–2953CrossRefPubMed Hamaoka T, Madewell JE, Podoloff DA, Hortobagyi GN, Ueno NT (2004) Bone imaging in metastatic breast cancer. J Clin Oncol 22(14):2942–2953CrossRefPubMed
29.
go back to reference Blum RH, Shasha D, Fleishman SB The multidisciplinary approach to bone metastases Review Article | May 31, 2003 | Bone Metastases, Cancer Complications, Palliative and Supportive Care, Oncology Journal Blum RH, Shasha D, Fleishman SB The multidisciplinary approach to bone metastases Review Article | May 31, 2003 | Bone Metastases, Cancer Complications, Palliative and Supportive Care, Oncology Journal
30.
go back to reference Rougraff BT, Kneisl JS, Simon MA (1993) Skeletal metastases of unknown origin. A prospective study of a diagnostic strategy. J Bone Joint Surg Am 75(9):1276–1281CrossRefPubMed Rougraff BT, Kneisl JS, Simon MA (1993) Skeletal metastases of unknown origin. A prospective study of a diagnostic strategy. J Bone Joint Surg Am 75(9):1276–1281CrossRefPubMed
31.
go back to reference Fidler M (1986) Anterior decompression and stabilization of metastatic spinal fracture. J Bone J Surg[Br] (68):83–90 Fidler M (1986) Anterior decompression and stabilization of metastatic spinal fracture. J Bone J Surg[Br] (68):83–90
32.
go back to reference Alan M, Levine AJA (ed) Pathologic fractures. Browner skeletal trauma, 4th ed Alan M, Levine AJA (ed) Pathologic fractures. Browner skeletal trauma, 4th ed
33.
go back to reference Coleman RE (2006) Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 12(20 Pt 2):6243s–6249sCrossRefPubMed Coleman RE (2006) Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 12(20 Pt 2):6243s–6249sCrossRefPubMed
34.
go back to reference Saifuddin DJSA, chapter 48, Bone tumors(2): Malignant lesion in Adam: Grainger and Allison’s diagnostic radiology,5th ed Saifuddin DJSA, chapter 48, Bone tumors(2): Malignant lesion in Adam: Grainger and Allison’s diagnostic radiology,5th ed
35.
36.
go back to reference Kilpatrick SE, Ward WG, Cappellari JO, Bos GD (1999) Fine-needle aspiration biopsy of soft tissue sarcomas: a cytomorphologic analysis with emphasis on histologic subtyping, grading, and therapeutic significance. Am J ClinPathol 112:179–188 Kilpatrick SE, Ward WG, Cappellari JO, Bos GD (1999) Fine-needle aspiration biopsy of soft tissue sarcomas: a cytomorphologic analysis with emphasis on histologic subtyping, grading, and therapeutic significance. Am J ClinPathol 112:179–188
37.
go back to reference Schweitzer ME, Gannon FH, Deely DM, O’Hara BJ, Juneja V (1996) Percutaneous skeletal aspiration and core biopsy: complementary techniques. AJR Am J Roentgenol 166(2):415–418CrossRefPubMed Schweitzer ME, Gannon FH, Deely DM, O’Hara BJ, Juneja V (1996) Percutaneous skeletal aspiration and core biopsy: complementary techniques. AJR Am J Roentgenol 166(2):415–418CrossRefPubMed
38.
go back to reference Bommer KK, Ramzy I, Mody D (1997) Fine-needle aspiration biopsy in the diagnosis and management of bone lesions: a study of 450 cases. Cancer 81(3):148–156CrossRefPubMed Bommer KK, Ramzy I, Mody D (1997) Fine-needle aspiration biopsy in the diagnosis and management of bone lesions: a study of 450 cases. Cancer 81(3):148–156CrossRefPubMed
Metadata
Title
Skeletal Metastasis—an Epidemiological Study
Authors
Balaji Zacharia
Dhiyaneswaran Subramaniam
Jerin Joy
Publication date
01-03-2018
Publisher
Springer India
Published in
Indian Journal of Surgical Oncology / Issue 1/2018
Print ISSN: 0975-7651
Electronic ISSN: 0976-6952
DOI
https://doi.org/10.1007/s13193-017-0706-6

Other articles of this Issue 1/2018

Indian Journal of Surgical Oncology 1/2018 Go to the issue